701 THE IMPACT OF ERECTILE FUNCTION ON THE CAVERNOUS NERVE QUANTITY IN THE RADICAL PROSTATECTOMY SPECIMEN

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Basic Research I1 Apr 2010701 THE IMPACT OF ERECTILE FUNCTION ON THE CAVERNOUS NERVE QUANTITY IN THE RADICAL PROSTATECTOMY SPECIMEN Shin-ichi Hisasue, Kohei Hashimoto, Ryoji Furuya, Motoi Takeuchi, Youki Kyoda, Toshihiro Maeda, Ko Kobayashi, Toshiaki Tanaka, Koji Ichihara, Ryuichi Kato, Hiroshi Kitamura, Satoshi Takahashi, Naoya Masumori, and Taiji Tsukamoto Shin-ichi HisasueShin-ichi Hisasue More articles by this author , Kohei HashimotoKohei Hashimoto More articles by this author , Ryoji FuruyaRyoji Furuya More articles by this author , Motoi TakeuchiMotoi Takeuchi More articles by this author , Youki KyodaYouki Kyoda More articles by this author , Toshihiro MaedaToshihiro Maeda More articles by this author , Ko KobayashiKo Kobayashi More articles by this author , Toshiaki TanakaToshiaki Tanaka More articles by this author , Koji IchiharaKoji Ichihara More articles by this author , Ryuichi KatoRyuichi Kato More articles by this author , Hiroshi KitamuraHiroshi Kitamura More articles by this author , Satoshi TakahashiSatoshi Takahashi More articles by this author , Naoya MasumoriNaoya Masumori More articles by this author , and Taiji TsukamotoTaiji Tsukamoto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1142AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent reports suggested that the nerve fiber outside of the neurovascular bundle (NVB) also plays an important role in erectile function following radical prostatectomy. However, there is no study investigating the factor contributing to the distribution of the cavernous nerve in human. We explored the distribution of nNOS-positive nerve fiber around the prostate and the contributing factors to the fiber quantity. METHODS We investigated 46 hemispheres of 23 non-nerve-sparing radical prostatectomy specimens. We analyzed the preoperative IIEF5 score and maximum penile circumferential change (MPCC) during a night. We divided prostatic hemisphere into 6 parts; 0-1, 1-2, 2-3, 3-4, 4-5, and 5-6 o'clock at apex, middle, and base of prostate respectively. We conducted the multivariate analysis to investigate the factors contributing to the overall nNOS-positive nerve fiber quantity using the variables including specimen weight, age, BMI, IIEF5 score > 17, and MPCC > 20mm. MPCC ≤ 20mm was considered as objective erectile dysfunction (ED). RESULTS Median age was 68 years (57-74). Median IIEF5 score was 12 (0-24) and median MPCC was 25.0 mm (2.70-38.3). The median number of the overall nNOS-positive nerve fibers around the prostatic hemisphere was 866 (156-2916). The distribution of nNOS-positive nerve fiber was 2.7% in 0-1, 6.4% in 1-2, 13.1% in 2-3, 30.4% in 3-4, 35.0% in 4-5, and 12.4% in 5-6 o'clock. Approximately, 65 % of fibers distributed in 3-5 o'clock of NVB area (p<0.001). Logistic regression analysis revealed that the MPCC was the single significant variable (p=0.027, OR 6.22, 95%CI 1.23-31.40). The fiber count was greater in the objective ED group (1500: 382-2760), than in the non-ED group (649: 156-2916) (p=0.009). The significant difference in the fiber count between 2 groups was seen in 3-6 o'clock, especially at apex (Fig). CONCLUSIONS This is the first report suggesting that the baseline erectile function impacts on the cavernous nerve fiber quantity. The current result suggested that cavernous nerve preservation around NVB at apex is still important, especially for the ED patients. Sapporo, Japan© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e273-e274 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shin-ichi Hisasue More articles by this author Kohei Hashimoto More articles by this author Ryoji Furuya More articles by this author Motoi Takeuchi More articles by this author Youki Kyoda More articles by this author Toshihiro Maeda More articles by this author Ko Kobayashi More articles by this author Toshiaki Tanaka More articles by this author Koji Ichihara More articles by this author Ryuichi Kato More articles by this author Hiroshi Kitamura More articles by this author Satoshi Takahashi More articles by this author Naoya Masumori More articles by this author Taiji Tsukamoto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...